Fact Sheet Number 108
Blood Sugar (Glucose) and
Fats (Cholesterol and Triglycerides)
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PrintANTIVIRAL MEDICATIONS?
Standard blood tests measure blood sugar (glucose) but not blood
fats. People with HIV are testing their blood sugar and blood
fat levels more frequently because anti-HIV drugs seem to cause
abnormally high levels. This is especially true for the anti-HIV
drugs called protease inhibitors. For more information, see Fact Sheet 553 on lipodystrophy
(body shape changes).
Glucose is sugar. It is broken down in the cells to
provide energy. Blood sugar increases after you eat or drink anything
besides water. A high glucose level (hyperglycemia) can be a sign
of the disease diabetes mellitus. High blood sugar levels can
eventually damage your eyes, nerves, kidneys or heart. High blood
sugar can be a side effect of the HIV protease inhibitors.
Low blood sugar (hypoglycemia) can cause fatigue, but there
are other more common causes of fatigue for people with HIV.
In a healthy person, blood sugar is controlled by insulin.
Insulin is a hormone produced by the pancreas. It helps glucose
move from your blood into your cells to produce energy.
High blood sugar levels could mean that your pancreas is not
making enough insulin. However, some people make plenty of insulin,
but their body doesn’t respond normally. This is called “insulin
resistance.” In either case, the cells don’t get enough glucose
to use for energy, and glucose builds up in your blood.
Some people who take HIV protease inhibitor medications develop
insulin resistance and can have high blood glucose levels. This
condition is sometimes treated with the same medications used
to treat diabetes. There is no simple blood test for insulin resistance.
There are three ways to test for blood glucose levels:
- A random blood glucose test. This measures the glucose
in a sample taken when you have been eating on your usual schedule.
- A fasting glucose test. This uses a blood sample taken
when you have not had anything to eat or drink (except water)
for at least 8 hours.
- A glucose tolerance test. This starts with a fasting
glucose test. Then you are given a measured amount of glucose
in a sweet drink. Glucose is measured in several more blood samples
taken at specific time intervals.
If your blood glucose is too high, you might have diabetes.
Treatment for diabetes involves weight loss, diet and exercise.
It can also involve medications or insulin shots.
Fat is a source of energy. It carries some vitamins around the
body. It is used to make hormones and cell membranes, to protect
organs and to lubricate some moving body parts. However, too much
fat in the blood increases the risk of heart disease or pancreatitis.
Triglycerides are the most common form of fat in the body.
Cholesterol is another form of fat. In order for fats to be carried
in the blood, they are wrapped in protein molecules. These bundles
of protein-wrapped fat are called lipoproteins.
Lipoproteins come in different sizes. Smaller ones are called
low-density lipoproteins (LDL) or very-low-density lipoproteins
(VLDL). These molecules carry fats from the liver to other parts
of the body. Too much LDL or VLDL can cause fat to build up on
the walls of your arteries. This can reduce the oxygen supply
to your heart muscle and cause heart disease or a heart attack.
Larger lipoproteins are called high-density lipoproteins (HDL).
These are called “good” lipoproteins because they remove
fats from your arteries and return them to the liver for more
processing. High levels of HDL seem to protect people from heart
disease.
Blood fats are measured as the amount (in milligrams) contained
in one tenth of a liter (a deciliter) of blood, or mg/dL.
Measuring Triglycerides
Triglyceride levels in the blood rise quickly after you eat. You
cannot eat for at least 8 hours before you give a blood sample.
Many people with HIV disease have unusually high levels of triglycerides.
This is especially true for people taking protease inhibitor drugs.
Triglyceride levels under 150 are considered normal. Levels greater
than 1000 mg/dL can cause pancreatitis.
Measuring Cholesterol
Total cholesterol includes the “bad”
low-density and the “good” high-density lipoproteins.
Total cholesterol does not change too quickly after you eat, so
you can give blood any time for this test. Total cholesterol levels
below 200 are considered good, and levels over 240 are considered
bad.
HDL Cholesterol is good cholesterol. It
can be measured in a non-fasting blood sample. Higher levels of
HDL cholesterol are better, and levels over 40 are considered
good.
LDL Cholesterol is bad cholesterol. LDL levels
are calculated using a formula that includes the level of triglycerides.
You need a fasting blood sample to measure triglycerides or to
calculate LDL cholesterol. Levels below 100 are good, and levels
over 160 are considered a high risk for heart disease.
HIV doctors are treating more of their patients with high cholesterol
levels, especially if the patients have a family history of heart
disease. If your cholesterol level is high, discuss treatment
options with your clinician.
Revised May 8, 2002
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